The lack of communication and a confusing reporting system left thousands of COVID-19 tests absent from SC Department of Health and Environmental Control reports to the public.
While the sub-count that has surfaced in recent weeks is small enough for agency leaders to say it does not affect how the state responds to the pandemic, the missing entries may hamper DHEC’s efforts to investigate cases and measure tests all the days.
DHEC says it has been telling laboratories and health groups for months to report its results. Some providers say that communication from state and national authorities has been irregular.
Only a few parties perform most of the COVID-19 tests in South Carolina: the state’s public health laboratory, the main external laboratories Quest Diagnostics and LabCorp and the Medical University of South Carolina. No major problems have been reported by these labs.
But on September 22, DHEC said it received news of 15,000 unreported tests from Augusta University Healthcare in Georgia. Three days later, the agency said it had received another 7,000 results from Doctors Care, an emergency care network.
“We want people to understand that the vast majority of laboratories and facilities are reporting their positive and negative results to DHEC, as needed,” said state epidemiologist Dr. Linda Bell.
Laboratories and healthcare providers have never had to report such a large amount of information and to multiple agencies, Bell said. DHEC also never had to track this volume of reports. The number of tests missed is probably a small part of the total 1.4 million tests between March 1 and the end of September, Bell added.
DHEC is still analyzing the numbers, but the agency does not believe that the missing tests significantly affect the state’s percentage of positivity – a key metric that indicates the speed with which the virus is spreading. But, if the agency does not know of positive test results, it will not be able to perform contact tracking.
“We don’t have a good way of knowing what we’re not getting,” said Bell.
Missing negatives
For months, several laboratories and hospitals did not report COVID-19 tests if they returned negative. During normal times, this is standard practice. But due to the crisis, public health officials want to track how many tests are being carried out in total.
Diatherix, a laboratory in Alabama that is conducting some tests in South Carolina, was among those that did not report negative results. The laboratory is owned by Eurofins Scientific, a publicly traded conglomerate based in Luxembourg. Diatherix is now working with South Carolina officials to report all of his results, retroactively.
Eurofins said in a statement that it was only notified of the need to report positive and negative tests last month. Federal health officials approved a rule on August 25 that required all laboratories to report positive and negative results. Companies that do not meet the standards by mid-September are subject to sanctions and fines.
“Most state agencies had varying reporting requirements during the course of the current pandemic,” the company’s investor relations team said in a statement. State health agencies are “heavily taxed” with changes in reporting requirements, “and they have all been doing their best to meet the public need for accurate data,” the company added.
Contacted by the Post and Courier, two South Carolina hospitals declined to say why they were not reporting all results to DHEC.
The state agency instructed Bon Secours St. Francis in Greenville to report negative and positive tests, according to hospital emails provided by DHEC. The hospital did not. Bon Secours did not respond to repeated requests for comment.
An Anmed Health spokeswoman in Anderson did not answer the question as to why the hospital system was not reporting negative results to the state health agency. As a result of the problem, thousands of hospital test results did not appear in DHEC counts. The spokeswoman said that between March and the end of August, Anmed Health’s negative tests totaled about 6,600.
Inconsistencies
Even with thousands of undisclosed tests, state leaders say they are reaching the goal of testing 500,000 Southern Carolinians a month. A Johns Hopkins University state ranking places South Carolina in 31st place in testing efforts.
Marshall Taylor, DHEC’s acting director, told state senators last week that the agency reminded labs of the need to report their numbers in early September, not long after WYFF-TV reported thousands of missed results.
Taylor said the problem was “not everyone is on an electronic system linked directly to the state’s health department”.
Whatever the exact problem, labs and providers say they received mixed messages.
DHEC reported the loss of 15,000 test results from Augusta University Healthcare, on the state border in Georgia, on September 22. September that the agency was not receiving.
DHEC provided a list of the number of COVID-19 tests from each laboratory to the Post and Courier. The information, which reflects the data between March 1st and …
A Doctors Care spokeswoman said the urgent care network had a process to report some of its tests, but not others, resulting in delayed notification of thousands of tests. Test reporting requirements also changed during the pandemic, the spokeswoman said.
“We have a long-standing relationship with DHEC and we respect the work they are doing to meet our state’s public health needs,” she said. “Our organization continues to make every effort to respond to changes in reporting.”
Rapid clinics are now automatically reporting all tests on a daily basis.
Other labs said they performed more tests than reflected in a DHEC report provided to The Post and Courier. A founder of Vikor Scientific, a laboratory in Charleston, said the company ran an average of 3,773 tests per month – the DHEC report shows only 379 between March 1 and July 16.
Primary care physicians in Palmetto, who started offering a quick COVID-19 test in Charleston in mid-June, initially reported all results to DHEC, a practice spokeswoman said. But then DHEC’s word came that it was only necessary to report positive results, which they did for two months this summer. The spokeswoman said DHEC reversed the course in late August, again instructing Palmetto’s primary care doctors to report positive and negative results.
The health agency recorded 22 positive tests in one month from practice. The reality was 703.
In an announcement on Wednesday, DHEC said it was improving its electronic reporting system. In the meantime, it is difficult to say whether more information from the labs may be missing.
Seanna Adcox contributed to this report.